crossing96/oncoscreening huggingface dataset:
Chemotherapy for bladder cancer: treatment guidelines for neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and metastatic cancer.	To determine the optimal use of chemotherapy in the neoadjuvant, adjuvant, and metastatic setting in patients with advanced urothelial cell carcinoma, a consensus conference was convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) to critically review the published literature on chemotherapy for patients with locally advanced bladder cancer. This article reports the development of international guidelines for the treatment of patients with locally advanced bladder cancer with neoadjuvant and adjuvant chemotherapy. Bladder preservation is also discussed, as is chemotherapy for patients with metastatic urothelial cancer. The conference panel consisted of 10 medical oncologists and urologists from 3 continents who are experts in this field and who reviewed the English-language literature through October 2004. Relevant English-language literature was identified with the use of Medline; additional cited works not detected on the initial search regarding neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and chemotherapy for patients with metastatic urothelial cancer were reviewed. Evidence-based recommendations for diagnosis and management of the disease were made with reference to a 4-point scale. Results of the authors' deliberations are presented as a consensus document. Meta-analysis of randomized trials on cisplatin-containing combination neoadjuvant chemotherapy revealed a 5% difference in favor of neoadjuvant chemotherapy. No randomized trials have yet compared survival with transurethral resection of bladder tumor alone versus cystectomy for the management of patients with muscle-invasive disease. Collaborative international adjuvant chemotherapy trials are needed to assist researchers in assessing the true value of adjuvant chemotherapy. Systemic cisplatin-based combination chemotherapy is the only current modality that has been shown in phase 3 trials to improve survival in responsive patients with advanced urothelial cancer. A panel of international experts has formulated grade A through D recommendations for the management of patients with locally advanced and metastatic urothelial cancer on the basis of level 1 to 3 evidence and the findings of phase 2 trials, prospective randomized clinical trials, and meta-analyses.	bladder
[Metastatic transitional cell carcinoma with high CA 19.9 serum levels].	We report the case of a 75-year-old woman with liver metastases of a urothelial carcinoma accompanied by a marked increased in CA 19-9 serum level. The mechanisms leading to this elevation, similar to that observed in biliary tract diseases, are discussed.	bladder
Molecular biology of bladder cancer.	Bladder cancer is a major cause of health expenses and it presents formidable clinical challenges. Two types of tumors have been identified, papillary and non-papillary. The former are mainly characterized by FGFR3 and chromosome 9 alterations and a low frequency of Tp53 alterations. The latter are characterized by a high frequency of alterations in genes in the p53 and Rb pathways. Chromosome 9 alterations, specially in 9q, are crucial to bladder cancer development and occur in both types of tumors. Progression of some superficial tumors (mainly TaG3 and T1G3) to high-grade, invasive, carcinomas provides evidence of some overlap between the two pathways. Distinct gene expression profiles have been identified in superficial and invasive tumors. The stage is now ready for the clinical application of this knowledge.	bladder
Extrapulmonary small cell carcinoma of the bladder.	Among the many sites for primary small cell cancer is the genitourinary system. The majority of cases have been observed in the bladder and prostate. Small cell carcinoma accounts for less than 1% of all bladder tumors. Definitive predisposing factors are unknown; however, small cell carcinoma of the bladder has been associated with cigarette smoking, long-standing cystitis, bladder calculus, and augmented cystoplasty. Contrary to the early theory of derivation from Kulchitsky cells, it is now believed that small cell carcinoma of the bladder originates from the totipotent stem cells present in the submucosa of the bladder wall. A number of chromosomal aberrations have been reported in small cell cancer of the bladder. There are no specific clinical features that differentiate these patients from transitional cell carcinoma of the bladder; however, some patients may have associated paraneoplastic conditions. Diagnosis is established by cystoscopic-assisted biopsy. Like small cell carcinoma of the lung, small cell carcinoma of the bladder has a propensity for early metastases. There is no standard therapy for small cell carcinoma of the bladder and the prognosis is poor; however, patients treated with cisplatin-based chemotherapy regimens seem to have a better prognosis.	bladder
"Peritonitis carcinomatosa in a patient with recurrent ""superficial"" bladder cancer treated with cystectomy and nephroureterectomy."	We report on a 45-year-old woman treated with cystectomy after failure of bacille Calmette-Guérin therapy for superficial transitional cell carcinoma. After 9 months, left-sided nephroureterectomy was performed for recurrence in the left ureter. The pathologic examination revealed carcinoma in situ and no tumor-positive lymph nodes (pTisN0Mx). At 2.5 years later, she complained of abdominal distension and pain. She underwent bilateral removal of the ovaries, infracolic omentectomy, and liver biopsy because of suspicious lesions on the liver. Pathologic examination revealed extensive peritoneal spread of transitional cell carcinoma. The seeding potential of high-grade urothelial cancer is well known; however, we found no clear explanation for the peritoneal spread of tumor cells in this patient that occurred years after the surgical procedures.	bladder
Reliability of frozen section examination of external iliac, hypogastric, and obturator lymph nodes during radical cystectomy: a multicenter study.	OBJECTIVES: To evaluate the accuracy of frozen section examination (FSE) for detecting lymph node (LN) metastasis in patients with bladder cancer undergoing radical cystectomy and pelvic LN dissection. To our knowledge, the accuracy of FSE to identify LN metastases in patients with bladder cancer is still undetermined. METHODS: The clinical data of 360 patients who had undergone radical cystectomy with pelvic lymphadenectomy for bladder cancer in six urologic institutions were retrospectively analyzed. The nodal regions included were the external iliac, hypogastric, and obturator LNs. The FSE results of the right and left LN regions were compared with the final histopathologic results of the respective LN regions. RESULTS: The final pathologic examination revealed nodal metastases in 65 patients (18.1%). Of the 720 right and left LN regions in 360 patients, 88 (12.2%) were metastatic at the final pathologic examination. Although the FSE findings were negative, the final pathologic examination revealed LN metastases in 26 patients and in 29 pelvic LN regions. All LN regions with positive FSE findings were positive at the final pathologic examination. When we considered the 720 LN regions, the sensitivity, specificity, and positive and negative predictive values for FSE were 67%, 100%, 100%, and 95.6%, respectively. CONCLUSIONS: Until innovations in imaging methods improve nodal staging in patients with bladder cancer, performing FSE of the external iliac, hypogastric, and obturator LNs seems to be a reliable procedure for the evaluation of the LNs. The information obtained with FSE of the LNs can be used to determine intraoperatively the extent of LN dissection.	bladder
Proceedings of the First International Conference on PEP005.	The sap of Euphorbia peplus, commonly know as 'petty spurge', 'radium weed' or 'milkweed' has been used for centuries as a traditional treatment for skin conditions, including warts, corns and cancers of the skin. Documentation of its use by medical professionals to treat basal cell carcinoma (BCC) dates from the early 19 century. Individuals who participated in a 1988 survey of home treatments for cancer indicated the sap of E. peplus was an effective cure for actinic lesions leading the investigators to suggest that this potential utility should be further explored in controlled clinical trials. The fractionation of the sap E. peplus using solvents of varying polarity yielded several macrocyclic diterpenes, many of which were found to have cytotoxic activity or the ability to influence cellular differentiation. Ultimately, ingenol 3-angelate (I3A) of PEP005, emerged as a promising potential new anti-cancer treatment. Here we report the proceedings from the First International Conference on PEP005, covering the exciting potential of PEP005 as the therapeutic agent for the treatment of skin cancer, leukemia and bladder cancer.	bladder
[Contribution of cell cycle and DNA content study by flow cytometry in the prognosis of superficial bladder cancer: Tunisian experience].	Clinico-pathological study of superficial bladder cancer (pTa/pT1) informs about prognostic factors such as the size of the tumor, its uni or multifocal character, its grade and stage. Presently, these factors constitute the basis of therapeutic decision but do not allow to foresee the prognosis with certainty. Many technics have contributed to a better knowledge of such tumors; however, they have not allowed to fully master prognostic uncertainties. During the last decades, cell cycle and DNA content study by flow cytometry has been developping, bringing an additional prognostic element to various types of tumors. We have decided to study the impact of this technique to the assessment of the prognosis of superficial bladder tumors. The study concerned 65 patients presenting superficial bladder tumors (pTa/ pT1), with a follow-up of at least two years in case of not recurrence and in case of recurrence, having had a second resection with analysis of sections. Flow cytometry was applied to formol-fixed and paraffin-embedded endoscopic resection material of initial tumors by simple-labelling of DNA with propidium iodide. Following cytometric study, 35 (54%) of tumors were aneuploid and 30 (46 %) were diploid. For the diploid ones, S-phase mean value was 14.94% (from 2.72% to 33.43%); and G2M mean value was 8.3 (from 1% to 18%). The presence of an DNA- aneuploid peak had a predictive value of recurrence and progression in stage, with relative risks of 12 and 6.85 respectively. It was also correlated with the histological grade and stage. On the other hand, S-phase and G2M values had no prognostic significance.	bladder
Significance of TWIST expression and its association with E-cadherin in bladder cancer.	Recently, TWIST, a basic helix-loop-helix transcription factor, has been reported to play a key role in the metastatic progression of several types of human cancer. The aim of this study was to investigate the significance of TWIST expression in bladder cancer using tissue microassays generated from 226 bladder tissue specimens. Using immunohistochemical staining, we studied TWIST expression levels in nonmalignant bladder tissues (n = 37), primary bladder cancer tissues (n = 164), and 25 cases of matched lymph node metastatic lesions. The association between TWIST expression levels and tumor staging and grading, as well as metastatic potential, was analyzed by statistical analysis. Our results showed that TWIST protein expression was significantly higher in bladder cancer specimens compared with nonmalignant tissues (P < .001), indicating its positive role in the development of bladder cancer. In addition, increased TWIST expression levels were associated with advanced-stage and high-grade tumors, suggesting its involvement in the progression of this cancer. Furthermore, TWIST expression was much higher in the metastatic lesion compared with its primary site (P < .05). More importantly, the increased TWIST expression in bladder cancer specimens was correlated with decreased membranous expression of E-cadherin, a cell adhesion molecule that plays a key role in the metastatic progression of human cancer. Our results demonstrate TWIST as a novel positive factor in the development and progression of bladder cancer and suggest a marker for advanced bladder cancer.	bladder
[Pronostic factors in recurrence and progression of superficial bladder cancer. Risk groups (part I)].	INTRODUCTION: We have carried out a retrospective study on a series of superficial bladder tumours, analyzing the clinical-pathological factors that can determine the subsequent evolution of the tumour as for recurrence and progression. MATERIAL AND METHODS: They were revised on the whole 473, of which finally 419 superficial bladder tumours were useful for the study (223 primary tumours and 196 recurrent). Studies are carried out univariate and multivariate on 24 variables of each tumour referred to the characteristics and to the evolution of the tumour. RESULTS: We find significant differences in the free time to recurrence, diminishing it in the tumours that recurred in less than 12 months, in multiple tumours (3 or more tumours) and in bladder dome tumours. Also statistically significant differences existed when were studied two homogeneous groups of surgeons, while the treatment with bladder instillations increased it. The time to progression, diminishes in: Tumours that had recurred prematurely (in 6 months), tumours over 3 cm, high grade tumours and when two groups of surgeons were studied, we also find that the maintenance therapy with BCG (bacillus Calmette-Guerin) showed a greater time to progression versus induction therapy. DISCUSSION: The independent factors to explain smaller free time till superficial recurrence were: recurrence in the 1 degree year, multiplicity, surgical technique, not employment of bladder washes, treatment with low dose of BCG and use of intravesical therapy with induction therapy versus maintenance. About the progression, we objectify that the factors with greater influence in the progression were, recurrence in the first 6 months, grade (grade 2 and grade 3 + Tis) and treatment with maintenance therapy versus induction.	bladder
[A case of inflammatory myofibroblastic tumor of the bladder].	Here we report a rare case of inflammatory myofibroblastic tumor of the bladder. The patient was a 72-year-old man. We diagnosed this case preoperatively as urachal tumor from urine cytology, cystoscopy, and magnetic resonance imaging. We performed partial cystectomy. Histopathological examination revealed that the tumor was an inflammatory myofibroblastic tumor. To our knowledge, this is the 51st reported case of inflammatory myofibroblastic tumor of the bladder in Japan. He has been followed up for 13 months without any evidence of local recurrence.	bladder
[A case of primary mucosa-associated lymphoid tissue lymphoma of the bladder regressed after rituximab in combination with CHOP chemotherapy].	Primary mucosa-associated lymphoid tissue (MALT) lymphoma of the bladder is a rare disease, and the most effective therapeutic procedure remains unknown. We report a case of primary MALT lymphoma of the bladder regressed after rituximab in combination with CHOP chemotherapy (R-CHOP). The patient, a 84-year-old woman, presented with general fatigue and loss of weight. Computed tomography (CT) showed a solitary mass at the bladder. Histological diagnosis of the tissue obtained by transurethral biopsy was extranodal marginal zone B cell lymphoma of MALT. The patient was in complete remission after only one cycle of R-CHOP. This is the fourteenth case of MALT lymphoma of the bladder in Japan.	bladder
DNA study of bladder papillary tumours chemically induced by N-butyl-N-(4-hydroxybutyl) nitrosamine in Fisher rats.	To examine DNA abnormalities in bladder papillary tumours induced by N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) in female rats, using image cytometric DNA analysis and cytogenetics. Thirty female rats were exposed to BBN in their drinking water for 20 weeks. One group of 10 animals served as controls. The animals exposed to BBN were killed at a rate of two per week, with the bladder being collected under aseptic conditions and those tumours with exophytic growth removed. The nuclear DNA content of the tumours was evaluated using image cytometric analysis. In two rats part of the tumour pieces was stipulated for culturing. Cytogenetic analysis was performed on at least 30 cells from each cell population and on both tumours. Papillary carcinomas were classified as low grade and high grade. DNA ploidy studies were carried out on 28 low-grade and 21 high-grade papillary carcinomas. Histograms obtained by image analysis showed that a normal urothelium was diploid; 28.6% and 100% of low-and high-grade papillary carcinomas were aneuploid respectively. Both tumours used for cell culture showed multiple numerical and structural chromosome alterations and several marker chromosomes. Image cytometric DNA analysis proved to be a good and reliable method for examining DNA alterations in papillary bladder carcinomas. The present findings establish that the DNA content is statistically different between low-grade and high-grade papillary carcinomas and that deviation from the diploid number is markedly higher in the high-grade ones. In addition, the occurrence of marker chromosomes seems to be related to the aggressiveness of the tumour.	bladder
Analysis of progression and survival after 10 years of a randomized prospective study comparing mitomycin-C and bacillus Calmette-Guérin in patients with high-risk bladder cancer.	OBJECTIVE: To report the 10-year follow-up of a study randomizing between instillations of bacillus Calmette-Guérin (BCG) and mitomycin-C (MMC) for treating high-risk and not muscle-invasive urinary bladder cancer to assess progression, the need for more aggressive treatment and survival (cancer-specific and overall), as many of the published studies comparing different treatments for disease that is not muscle-invasive have a short follow-up. PATIENTS AND METHODS: Between 1987 and 1992, 261 patients were included; they had frequently recurring Ta/T1G1-G2, T1G3 or primary Tis-dysplasia. The patients were randomized to treatment with either 40 mg of MMC or 120 mg of BCG (Danish strain 1331) given weekly for 6 weeks, then monthly up to a year and finally every third month for a further year. The 250 evaluable patients were followed using hospital files and national registers on causes of death. RESULTS: The median follow-up for survivors was 123 months. The disease progressed in 58 (23%) of the patients, 34 in the MMC group and 24 in the BCG group (P = 0.26). Of the 140 patients who died, 68 were in the BCG and 72 in the MMC group (log-rank P = 0.98); most (95, 68%) died from other causes. CONCLUSION: Based on the follow-up of the present patients it cannot be concluded that the drugs originally administered, MMC or BCG, differed in their effect on progression, need for subsequent treatment or survival.	bladder
FGFR3 mutations and a normal CK20 staining pattern define low-grade noninvasive urothelial bladder tumours.	OBJECTIVES: Molecular markers superior to conventional clinicopathologic parameters are needed to predict disease courses in bladder cancer patients. In this study, we investigated four markers (Ki-67, TP53, CK20, FGFR3) in primary urothelial bladder tumours and compared them with traditional pathologic features. METHODS: Tissue microarrays were used to analyse CK20, TP53, and Ki-67 expression immunohistochemically in 255 unselected patients. FGFR3 mutations were detected by SNaPshot analysis. RESULTS: Abnormal CK20 expression was strongly associated with higher tumour grades and stages (p < 0.001); however, 65% of pTa tumours revealed an abnormal CK20 pattern. In the group of pTaG1 tumours, 59% presented with an abnormal CK20 pattern, whereas 82% carried the FGFR3 mutation. In the group of bladder tumours with normal CK20 pattern, the FGFR3 gene was mutated in 89%, whereas a mutated FGFR3 gene was found in only 37% of cases with abnormal CK20 expression (p < 0.001). All markers proved to be strong predictors of disease-specific survival in univariate studies. However, in multivariate analyses they were not independent from classical pathologic parameters. None of the molecular markers was significantly associated with tumour recurrence. CONCLUSIONS: Dysregulation of CK20 expression is an early event in the carcinogenesis of papillary noninvasive bladder cancer, but occurs later than FGFR3 mutations. The group of low-grade noninvasive papillary tumours is defined by the presence of an FGFR3 mutation and a normal CK20 expression pattern.	bladder
Telomerase activity, cytokeratin 20 and cytokeratin 19 in urine cells of bladder cancer patients.	AIM OF THE STUDY: This work aims to search for markers suitable for the screening of bladder cancer, which should be specific, sensitive, reproducible, non-invasive and at acceptable cost. PATIENTS AND METHODS: The study included 50 patients diagnosed as bladder cancer (35 TCC, 15 SCC) of different stages and grades, 30 patients with various urothelial diseases, besides 20 apparently healthy subjects of matched age and sex to the malignant group. A random midstream urine sample was collected in a sterile container for the determination of telomerase by RT-PCR, keratin 19 by ELSA CYFRA 21-1 IRMA kit, keratin 20 by RT-PCR and immunohistochemical staining, and urine cytology. RESULTS: For all parameters (telomerase, K19, K20 and cytology) the malignant group was significantly different from both the benign and the control groups. None of the four studied parameters was correlated to the stage of the disease, and when it comes to grade, only K19 showed a significant positive correlation with grade both in TCC and SCC. When ROC curves for all parameters were compared, K19 had the largest area under the curve, and then comes K20. CONCLUSION: K 19 may be used as a biological marker for the diagnosis of bladder cancer. K19 could not be used for differential diagnosis of different types of bladder cancer, meanwhile it could be a marker for differentiation that decreases in less differentiated tumors. As a tumor marker, K20 reflects inability to differentiate tumor type or grade in TCC, while in SCC of the bladder it is correlated with the grade. As a method, RT-PCR is superior to immunostaining for the detection of bladder cancer, meanwhile K20 immunohistochemistry (IHC) results were much better than urine cytology as a bladder cancer screening test. Haematuria and inflammation reduced the specificity of telomerase assay, which reduced its validity as a tumor marker of bladder cancer. K19 and K20 are the best candidates as screening tests for the diagnosis of bladder cancer, representing the highest sensitivity and specificity, beside the radiological and histopathology. Meanwhile, telomerase, although it was a sensitive enough marker, it reflected a high false positive rate.	bladder